Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996-2018 (original) (raw)
Related papers
The Journal of nutrition, 2017
Child linear growth sometimes improves in both intervention and comparison groups in evaluations of nutrition interventions, possibly because of spillover intervention effects to nonintervention areas or improvements in underlying determinants of nutritional change in both areas. We aimed to understand what changes in underlying socioeconomic characteristics and behavioral factors are important in explaining improvements in child linear growth. Baseline (2010) and endline (2014) surveys from the Alive & Thrive impact evaluation were used to identify the underlying determinants of height-for-age z scores (HAZs) among children aged 24-48 mo in Bangladesh (n = 4311) and 24-59 mo in Vietnam (n = 4002). Oaxaca-Blinder regression decompositions were used to examine which underlying determinants contributed to HAZ changes over time. HAZs improved significantly between 2010 and 2014 in Bangladesh (∼0.18 SDs) and Vietnam (0.25 SDs). Underlying determinants improved substantially over time an...
Public Health Nutrition
Objective Childhood stunting remains a major public health concern in Bangladesh. To accelerate the reduction rate of stunting, special focus is required during the first 23 months of a child’s life when the bulk of growth takes place. Therefore the present study explored individual-, maternal- and household-level factors associated with stunting among children under 2 years of age in Bangladesh. Design Data were collected through a nationwide cross-sectional survey conducted between October 2015 and January 2016. A two-stage cluster random sampling procedure was applied to select 11 428 households. In the first stage, 210 enumerations areas (EA) were selected with probability proportional to EA size (180 EA from rural areas, thirty EA from urban slums). In the second stage, an average of fifty-four households were selected from each EA through systematic random sampling. Setting Rural areas and urban slums of Bangladesh. Participants A total of 6539 children aged 0–23 months. Resul...
Factors affecting stunting among under-five children in Bangladesh
Family Medicine & Primary Care Review
Background. Stunting is a major contributor to child morbidity and mortality in developing countries. Knowledge about the risk factors of stunting among children under five years of age is important for devising nutritional intervention programs and strategies. Objectives. This study attempts to uncover the risk factors associated with stunting status among children under five years of age in bangladesh. Material and methods. This study uses Bangladesh Demographic and Health Survey (BDHS) 2014 data collected from an observational study. The ordinal dependent variable, child stunting status (categorized as severely stunted, moderately stunted and normal) is constructed by calculating height-forage Z scores (HAZ). The bivariate analyses were performed using chi-square test to explore possible associations between stunting status and selected covariates. To know the marginal effects of independent variables, the proportional odds (PO) model was considered. Results. In bivariate setup, all the selected independent variables were found to be highly significant (p < 0.01). However, in multivariate analyses, child age, mother's education, mother's BMI and wealth index were found to be highly significant (p < 0.01) factors for the stunting status of children. The risk of having stunted children was found relatively higher in Chittagong (odds ratio = 1.466, p < 0.05), Sylhet (odds ratio = 1.345, p < 0.05) and Rangpur (odds ratio = 1.276, p < 0.1), compared to the Barisal division. Along with this, the birth interval of children (p < 0.05) and antenatal care service during pregnancy (p < 0.1) were found to be associated with child stunting status. Conclusions. Child age, mother's education, mother's BMI and wealth index were the most significant determinants in this study. Hence, policy makers should consider these factors while devising child nutrition programs and intervention strategies.
BMC public health, 2018
Bangladesh is one of the 20 countries with highest burden of stunting globally. A large portion (around 2.2 million) of the population dwells in the slum areas under severe vulnerable conditions. Children residing in the slums are disproportionately affected with higher burden of undernutrition particularly stunting. In this paper, findings of a prospective cohort study which is part of a larger multi-country study are presented. Two hundred and sixty five children were enrolled and followed since their birth till 24 months of age. Anthropometric measurements, dietary intake and morbidity information were collected monthly. Data from 9 to 12, 15-18 and 21-24 months were collated to analyze and report findings for 12, 18 and 24 months of age. Generalized estimating equation models were constructed to determine risk factors of stunting between 12 and 24 months of age. Approximately, 18% of children were already stunted (LAZ < -2SD) at birth and the proportion increased to 48% at 24...
Current Developments in Nutrition, 2021
ABSTRACTBackgroundCauses of infant linear growth faltering in low-income settings remain poorly understood. Identifying age-specific risk factors in observational studies might be influenced by statistical model selection.ObjectivesTo estimate associations of selected household factors and infant feeding behaviors within discrete age intervals with interval-specific changes in length-for-age z-scores (LAZs) or attained LAZ, using 5 statistical approaches.MethodsData from a birth cohort in Dhaka, Bangladesh (n = 1157) were analyzed. Multivariable-adjusted associations of infant feeding patterns or household factors with conditional LAZ (cLAZ) were estimated for 5 intervals in infancy. Two alternative approaches were used to estimate differences in interval changes in LAZ, and differences in end-interval attained LAZ and RRs of stunting (LAZ < −2) were estimated.ResultsLAZ was symmetrically distributed with mean ± SD = −0.95 ± 1.02 at birth and −1.00 ± 1.04 at 12 mo. Compared with ...
Food and nutrition bulletin, 2018
Despite improvements in the reduction of child stunting rates over the last decade, poor nutritional status still remains a public health concern in Bangladesh, where young children are the most vulnerable. The objective of this study is to capture the prevalence and determinants of childhood stunting and documenting its urban-rural disparities in the context of Bangladesh. The study used data from the Bangladesh Demographic and Health Survey of 2014. A bivariate analysis was performed to find out the differentials in prevalence of stunting, and multivariate logistic regression was performed to also assess the association of stunting with potential risk factors. The overall prevalence of stunting was 36.3% and was significantly higher in rural (38.1%) areas than urban (31.2%) areas. In all 3 regression models, significantly higher odds were found among children aged 36 to 47 months compared to 6 to 12 months and among the children from the poorest households. In rural areas, male ch...
Factors affecting stunting among children under five years of age in Bangladesh
Family Medicine & Primary Care Review, 2018, 20(4): 356–362, 2018
Background: Stunting is a major contributor to child morbidity and mortality in developing countries. Knowledge about the risk factors of stunting among children under five years of age is important for devising nutritional intervention programs and strategies. Objectives: This study attempts to uncover the risk factors associated with stunting status among children under five years of age in Bangladesh. Material and methods: This study uses Bangladesh Demographic and Health Survey (BDHS) 2014 data collected from an observational study. The ordinal dependent variable, child stunting status (categorized as severely stunted, moderately stunted and normal) is constructed by calculating height-forage Z scores (HAZ). The bivariate analyses were performed using chi-square test to explore possible associations between stunting status and selected covariates. To know the marginal effects of independent variables, the proportional odds (PO) model was considered. Results: In bivariate setup, all the selected independent variables were found to be highly significant (p < 0.01). However, in multi-variate analyses, child age, mother's education, mother's BMI and wealth index were found to be highly significant (p < 0.01) factors for the stunting status of children. The risk of having stunted children was found relatively higher in Chittagong (odds ratio = 1.466, p < 0.05), Sylhet (odds ratio = 1.345, p < 0.05) and Rangpur (odds ratio = 1.276, p < 0.1), compared to the Barisal division. Along with this, the birth interval of children (p < 0.05) and antenatal care service during pregnancy (p < 0.1) were found to be associated with child stunting status. Conclusions: Child age, mother's education, mother's BMI and wealth index were the most significant determinants in this study. Hence, policy makers should consider these factors while devising child nutrition programs and intervention strategies.
Malaysian journal of nutrition, 2011
Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father's education, toilet facilities, child's age, birth order of children and wealth index were also important de...
Correlates of stunting among under-five children in Bangladesh: a multilevel approach
BMC Nutrition, 2019
Background Child malnutrition still remains a major cause of childhood morbidity and mortality in Bangladesh. This study aims to determine the prevalence and identify the associated risk factors of child malnutrition in Bangladesh using multilevel logistic regression model on data from the Bangladesh Demographic and Health Survey (BDHS), 2014. Methods A total sample of 6965 children aged 0–59 months was extracted from BDHS 2014. We performed descriptive analysis and multilevel generalized linear regression analysis with clustered data structure. Results Our findings show that among children the prevalence of moderate and severe values was respectively: 25 and 12% for stunting; 11 and 3.1% for wasting; 25 and 7.9% for underweight. The probability of stunting increased with age, with highest rate among children aged 36–47 months, which was significantly higher than children aged less than 6 months (OR = 6.71, 95% CI = 4.46, 10.10). Female children are found to be 11% less likely to be...
Public Health Nutrition, 2009
Objective: Despite a strong relationship between household food security and the health and nutritional status of adults and older children, the association of household food security with the growth of infants and young children has not been adequately studied, particularly in developing countries. We examined the association between household food security and subsequent growth of infants and young children in rural Bangladesh. Design: We followed 1343 children from birth to 24 months of age who were born in the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) study in rural Bangladesh. A food security scale was created from data collected on household food security from the mothers during pregnancy. Data on weight and length were collected monthly in the first year and quarterly in the second year of life. Anthropometric indices were calculated relative to the 2006 WHO child growth standards. Growth trajectories were modelled using multilevel models for change controlling for possible confounders. Results: Household food security was associated (P , 0?05) with greater subsequent weight and length gain in this cohort. Attained weight, length and anthropometric indices from birth to 24 months were higher (P , 0?001) among those who were in food-secure households. Proportions of underweight and stunting were significantly (P , 0?05) lower in food-secure households. Conclusions: These results suggest that household food security is a determinant of child growth in rural Bangladesh, and that it may be necessary to ensure food security of these poor rural households to prevent highly prevalent undernutrition in this population and in similar settings elsewhere in the world.